Sir.—Bortz et al1 described an American family of four (mother, father, and two sons) with supernumerary nipples but without associated renal anomalies. They commented that familial polythelia as a single congenital anomaly is not associated with renal anomalies.

Bortz et al also referred to three previously reported cases of families with familial polythelia. Two families were presented by Hersh et al2 and the third family by Klinkerfuss.3 The two families described by Hersh et al both had significant associated renal anomalies. In one family the mother had a renal cyst and her daughter had a multicystic kidney. In the second family the father had hydronephrosis and his son had a small but normally functioning kidney.

We are aware of several other examples of the familial occurrence of polythelia. Birkenfeld4 reported the occurrence of polythelia in twins. Marie5 described a family with 20 members in